Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, Georgia.
J Infect Dis. 2011 Jun 1;203(11):1517-25. doi: 10.1093/infdis/jir115. Epub 2011 Apr 28.
On 12 February 2008, an infected Swiss traveler visited hospital A in Tucson, Arizona, and initiated a predominantly health care-associated measles outbreak involving 14 cases. We investigated risk factors that might have contributed to health care-associated transmission and assessed outbreak-associated hospital costs.
Epidemiologic data were obtained by case interviews and review of medical records. Health care personnel (HCP) immunization records were reviewed to identify non-measles-immune HCP. Outbreak-associated costs were estimated from 2 hospitals.
Of 14 patients with confirmed cases, 7 (50%) were aged ≥ 18 years, 4 (29%) were hospitalized, 7 (50%) acquired measles in health care settings, and all (100%) were unvaccinated or had unknown vaccination status. Of the 11 patients (79%) who had accessed health care services while infectious, 1 (9%) was masked and isolated promptly after rash onset. HCP measles immunity data from 2 hospitals confirmed that 1776 (25%) of 7195 HCP lacked evidence of measles immunity. Among these HCPs, 139 (9%) of 1583 tested seronegative for measles immunoglobulin G, including 1 person who acquired measles. The 2 hospitals spent US$799,136 responding to and containing 7 cases in these facilities.
Suspecting measles as a diagnosis, instituting immediate airborne isolation, and ensuring rapidly retrievable measles immunity records for HCPs are paramount in preventing health care-associated spread and in minimizing hospital outbreak-response costs.
2008 年 2 月 12 日，一名受感染的瑞士旅行者前往亚利桑那州图森市的 A 医院就诊，由此引发了一起主要与医疗保健相关的麻疹暴发，共涉及 14 例病例。我们调查了可能导致医疗保健相关传播的危险因素，并评估了与暴发相关的医院费用。
通过病例访谈和病历回顾获取流行病学数据。审查医务人员（HCP）免疫记录，以确定非麻疹免疫的 HCP。从 2 家医院估算与暴发相关的费用。
在 14 例确诊病例中，7 例（50%）年龄≥18 岁，4 例（29%）住院，7 例（50%）在医疗保健环境中感染麻疹，且所有病例（100%）均未接种疫苗或疫苗接种情况未知。在 11 例（79%）有症状时就诊的患者中，1 例（9%）在出疹后立即戴口罩并隔离。从 2 家医院获取的 HCP 麻疹免疫数据证实，7195 名 HCP 中有 1776 名（25%）缺乏麻疹免疫力证据。在这些 HCP 中，139 名（9%）接受麻疹免疫球蛋白 G 检测的 HCP 结果为阴性，包括 1 名感染麻疹的患者。这 2 家医院共花费 799136 美元应对和控制这 2 家医院的 7 例病例。
怀疑麻疹为诊断，立即采取空气传播隔离，并确保医务人员麻疹免疫力记录易于检索，对于预防医疗保健相关传播和将医院暴发应对成本降至最低至关重要。
